Mild global cortical atrophy, F(47) 3/4

[Orangeblossom]

Hello there, I was quite active on here a few years back. I've recently had worsening short term memory and been referred to a memory clinic here in the UK. Had screening tests for eg. vitamin levels, blood sugar levels etc (all ok but slightly raised cholesterol)

Anyway, I had a head CT scan which has come back with mild global cortical atrophy and widening of the fissures. No changes to the hippocampus and rest normal.

I'm on HRT and try and follow the recommendations on here, but have had a difficult time with shingles and fatigue the last few years, including an episode on the face. Also have this difficult bowel condition which means I have to follow a low fibre diet.

I wondered if anyone else was in the same boat / similar? Thanks.

[NF52]

Hello there, I was quite active on here a few years back. I've recently had worsening short term memory and been referred to a memory clinic here in the UK. Had screening tests for eg. vitamin levels, blood sugar levels etc (all ok but slightly raised cholesterol)

Anyway, I had a head CT scan which has come back with mild global cortical atrophy and widening of the fissures. No changes to the hippocampus and rest normal.

I'm on HRT and try and follow the recommendations on here, but have had a difficult time with shingles and fatigue the last few years, including an episode on the face. Also have this difficult bowel condition which means I have to follow a low fibre diet.

I wondered if anyone else was in the same boat / similar? Thanks.

Welcome back, Orangeblossom! I'm so sorry that you have been dealing with what sounds like a nasty case of shingles, and maybe post-shingles pain and fatigue, while the rest of us were mostly concerned with COVID. It's got to be especially hard to deal with that while raising kids, as you've mentioned in the past, and dealing with mid-life hormone issues and other medications that you've mentioned in the past.

The really good news is that your hippocampus, the center for new learning and retrieving stored learning, is doing fine. It's possible that the short-term memory issues you've experienced will themselves be "short-term" as your shingles pain and fatigue, and associated stress and maybe not-so-great sleep improve.

The term "mild" can encompass a wide span in medicine and most quantitative measurements. The fissures in the brain (which my non-neurologist brain thinks of as folds between our various brain regions that allow us to pack a lot of brain power in a small space), do widen a bit year by year, even when we're in our 30's and 40's, as our brain slightly shrinks in size. From what you've posted before, it sounds like you have done an exceptional job in managing multiple health conditions that would have felled an ox --or many people of less determination.

I'm someone with ApoE 4/4 and a strong family history of heart disease and Alzheimer's and vascular dementia. I've had "elevated amyloid plaques" since at least 2017 at age 65. An article I saw in 2014 told me the "average" age of Alzheimer's diagnosis for people like me is 68. Yet at age 72, I am still here and doing fine! So I've decided to ignore some of those terms and focus more on what I can control, and how I feel day by day, look for research trials I can join and realize that I do best when I feel empowered, not discouraged.

I hope you have the support from your family, your friends, your doctors and your wonderful brain to also feel that this news is only one tiny part of who you are.

Nancy

[Orangeblossom]

Thanks for your lovely message Nancy, all the best to you! I'm also going through menopause recently so I expect that is adding to it all

[TCHC]

Hello there, I was quite active on here a few years back. I've recently had worsening short term memory and been referred to a memory clinic here in the UK. Had screening tests for eg. vitamin levels, blood sugar levels etc (all ok but slightly raised cholesterol)

Anyway, I had a head CT scan which has come back with mild global cortical atrophy and widening of the fissures. No changes to the hippocampus and rest normal.

I'm on HRT and try and follow the recommendations on here, but have had a difficult time with shingles and fatigue the last few years, including an episode on the face. Also have this difficult bowel condition which means I have to follow a low fibre diet.

I wondered if anyone else was in the same boat / similar? Thanks.

Hi OrangeBlossom

It's lovely to see a fellow Brit here.

I'm thinking that fatigue and shingles and a bowel condition are all going to be impacted by stress, which will also impact your hormones. How are you managing your stress?

I know I went through a period of stress that really did affect my health, but honestly, at the time, I wouldn't have said I was stressed! I would have said I was handling it.

At an earlier time in my life I also got shingles, but only about 6 months after a stressful time. Then I later found out that that is often how it happens. The symptoms come out much later.

I hope you've found some soothing things to do to give a bit of respite between any stressful times in the day?

Lindsey

[Orangeblossom]

Thanks Lindsey, yes it is all quite stressful, I do swimming a lot which helps. I also enjoy music and find that relaxing. I had really bad fatigue for ages after the shingles which was on my face / ear...(I have read this can be linked with cognitive problems also) but thankfully after about a year the fatigue is a bit better.

I have found that my memory clinic appointment is now next month as they had a cancellation, I have asked them if I should get a PET scan but they said no, as already had a CT and didn't want anymore radiation to my head. So I will find out then if they want to do anymore scans or tests. Feeling a bit nervous, but we're lucky to have a centre of research into brain health in the city, so it will be interesting to see what they say and look into the research they are doing.

One of the studies I have noticed was about ketones, and diet, another about dental hygiene and included free hygienist treatment monthly- this could be good as it is hard to find a NHS dentist now and the hygienist treatments are expensive!

I am wondering if I do get a 'diagnosis' maybe cognitive impairment, they might follow up with me and I can stay in contact regarding such research etc and maybe help others in the process. I'm still worried, but that is me trying to be positive (as so many of you on this site are)

[Orangeblossom]

Just to update this, I have had the memory clinic appt and they did not find significant memory loss but due to the mild atrophy have recommended a PET scan.

They seem unsure if it is normal to have mild atrophy at my age- anyone know?

I'm not sure yet what kind of scan, a glucose or amyloid one but think it is the glucose one. I will see then more of what is going on.

[Orangeblossom]

I got the referral through for the PET scan and it does not specify what type, also it says the atrophy is 'out of proportion to her age' so that answers my question.

[SusanJ]

I got the referral through for the PET scan and it does not specify what type, also it says the atrophy is 'out of proportion to her age' so that answers my question.

Extra hugs as you go forward with the PET scan.

Menopause seems to come with various unwelcome problems - are you doing or planning to do HRT?

[Orangeblossom]

Thanks! Yes, I'm on HRT already. they asked about that when referring me to the memory clinic (if it had changed anything). It hasn't unfortunately.

[NF52]

I got the referral through for the PET scan and it does not specify what type, also it says the atrophy is 'out of proportion to her age' so that answers my question.

Hi Orangeblossom,

My guess is that it's an amyloid PET scan, rather than an FDG-PET, which seems to now be used less often in clinical practice. The amyloid PET will show if you have amyloid plaques and give a score in what is called "centiloids". Having amyloid in your brain doesn't mean that you have mild cognitive impairment or Alzheimer's dementia--I had elevated levels of amyloid plaques on a PET scan when I was 65, as did several of my friends in the Generations trial--one of whom loved to win both bridge and gold tournaments. We all had cognition within the normal range.

The procedure itself is painless and you should have the results within a week or so. You may want to bring questions when you meet with the doctor or team to get the results, and I think it's helpful to have someone you trust with you so that you can then go get some coffee or take a walk--no matter what the results and say "what did you hear that I missed?"

Nancy